As people age, the senses through which they come to know the world often deteriorate, altering what they can see and hear.

In turn, that changes how older people function and interact with others, sometimes with unfortunate consequences.

Seniors may withdraw from friends and family, becoming isolated and depressed, because they can't understand what people are saying to them.

They may be unable to see clearly at night upon awakening, and trip and fall on their way to the bathroom.

The label on a pill bottle may be impossible to read — the type is so small! — and older adults may take too many or too few pills without knowing it.

When a senior is having problems hearing and asks the same question repeatedly, he or she may be mistaken as having short-term memory loss or dementia.

A doctor's instructions may be unattended because they weren't clearly heard. Without sensory stimulation, an older adult may begin to lose mental alertness and responsiveness.

Often, vision and hearing problems go unrecognized because symptoms come on gradually over time and doctors don't inquire about them.

"Sensory impairments in the elderly are routinely overlooked," says Margaret Wallhagen, director of the John A. Hartford Center of Geriatric Nursing Excellence at the University of California, San Francisco.

For many older adults, these difficulties, especially hearing problems, are a source of embarrassment or shame.

"It's a symbol of 'I'm old' and people don't want to confront that," Wallhagen said.

Warning signs can include an older relative who says "no" every time he or she is invited out to a restaurant or a family gathering; someone who stops reading or watching TV or, conversely, turns up the volume on the TV full-blast; an older man or woman who repeatedly asks "What did you say?" or who doesn't seem to be paying attention to a conversation; and a relative who expresses some concern about driving at night, experts say.

The most common cause of vision loss in adults over 65 is "refractive error" (a problem with focusing light) and this frequently can be corrected by getting new glasses, said Dr. Jane Potter, chief of geriatric medicine at the University of Nebraska.

She recommends that adults over age 65 have an eye examination every other year to check for abnormalities in vision, including glaucoma and cataracts, which also become more common with age.

A common cause of hearing loss is impacted ear wax, which can be cleaned out in a doctor's office. Technological advances have made hearing aids more effective, and cochlear implants are a good alternative for older adults with profound hearing loss, Potter said.

She recommends hearing tests for seniors every five years unless serious symptoms surface earlier.

Families can help by recognizing a loved one's impairment and making adaptations. Sometimes family members compensate by becoming a "go-between" for an older relative with hearing problems, "telling them everything that's going on around them," Wallhagen said. While well-intentioned, this strategy can diminish the older person's alertness and should be used cautiously, she recommends.

The bottom line: Don't accept a senior's poor vision or hearing as "normal" for their age. Have them medically evaluated, and research products and devices that can help. Even small changes can make a big difference.

Light the room brightly and use more than one non-glare light in a room.

Use blinds or shades to reduce glare.

Keep a night light on in the bedroom, hallway and bathroom.

Increase lighting on stairwells and steps.

Mark the edge of steps with a brightly colored tape or different colored paint. Paint handrails.

Turn lighting away from the TV to avoid glare.

Use concentrated light for reading.

Provide audio books and music for cognitive simulation, entertainment and relaxation.

Know the warning signs of possible vision problems: pain in and around the eyes, excessive tearing or discharge, double vision, dimness or distortion of vision, flashes of light, halos or floating spots, swelling of the eyelids, protruding eye, changes in eye color.

For someone with hearing problems:

Sensory challenges

A new report from the National Center for Health Statistics documents hearing and vision problems in people age 70 and older. Reviewing national data from 1999 to 2006, researchers found that 15.4 percent had vision problems and 26.3 percent had hearing impairments.

As we age, these difficulties accelerate: Twice as many 80-somethings reported compromised hearing and vision as 70-something seniors.

Poverty compounds the problem when older men and women put off getting medical attention and buying eyeglasses or hearing aids that can help correct sensory deficiencies. Indeed, vision problems are 50 percent more likely among impoverished seniors.

But unmet needs extend well beyond those with limited resources. Nearly 60 percent of older adults with vision problems don't use eyeglasses or have glasses that don't adequately correct their problems, the new report notes. Almost 80 percent of seniors with hearing loss in at least one ear aren't using hearing aids when they should.

Financial issues may be responsible, at least in part. Medicare doesn't pay for glasses or hearing aids, except under limited circumstances, forcing seniors to come up with the money, which many can't.

— J.G.

For someone with vision problems:

Get the older person's attention before speaking.

Look directly at his or her face.

Speak clearly, not too fast nor too slow. Don't shout.

Try using different phrases with the same meaning if you're not getting your point across.